Provider Information for 1073072641
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Mrs. RHEANNON CHAVEZ LMFT
Sex: Female
NPI: 1073072641
Last Updated: 2022-08-31
Certification Date: 2022-08-31
Certification Date: 2022-08-31
Details
| Name | Value | ||||||||||||
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| NPI | 1073072641 | ||||||||||||
| Enumeration Date | 2019-03-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 108 W VICTORIA ST GARDENA, CA 90248-3523 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 108 W VICTORIA ST GARDENA, CA 90248-3523 United States Phone: 310-715-2020 | Fax: | ||||||||||||
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